The cement mantle of femoral hip implants is more influenced by stem-broach sizing than by shape: an in vitro CT analysis of straight Charnley-Kerboul and anatomic Lubinus SPII stems

Introduction

Both, the stem shape and the implantation technique could influence the quality of the cement mantle surrounding femoral hip implants. We investigated which of these two factors is most important for the stem–cement–bone construct.

Methods

We compared morphological data of 22 straight Charnley-Kerboul and 18 anatomic Lubinus SPII plastic replicas implanted line-to-line with the broach or one size undersized in paired cadaver femora. Specimens were CT scanned and assessed with validated segmentation software.

Results

According to a general linear model, the canal-filling capacity of the stem, the cement thickness, the amount of thin and deficient cement and cortical support to areas of weak cement, were exclusively related to the implantation technique. The anatomic shape of Lubinus stems did not improve centralization or alignment.

Conclusion

Stem shape was the most obvious difference between Lubinus SPII and Chanrley-Kerboul implants. However, comparing both, stem-broach sizing was the most important determining factor for the cemented stem construct.